IJPR.2021.161

Type of Article:  Original Research

Volume 9; Issue 4 (August 2021)

Page No.: 3968-3973

DOI: https://dx.doi.org/10.16965/ijpr.2021.161

How Do Physiotherapists Treat People with Knee Osteoarthritis and their evidence awareness: A cross-sectional survey among Indian Physiotherapists

Pranav Saha ¹, Tenzin Yangchen ¹, Shaili Sharma ¹, Jaspinder Kaur ¹, Tsetan Norboo ¹, Ammar Suhail *².

¹ BPT 4^th Year, Department of Physiotherapy, Lovely Professional University, Phagwara, Punjab, India.

^*2 Assistant Professor, Department of Physiotherapy, Lovely Professional University, Phagwara, Punjab, India.

Corresponding Author: Ammar Suhail, Assistant Professor, Department of Physiotherapy, Lovely Professional University, Phagwara, Punjab, India. Phone no: +91-9718254388
E-Mail: asuhail38@gmail.com,  ammar.19815@lpu.co.in

ABSTRACT

Background: Evidence-based practice in the field of physiotherapy is of utmost importance and is the way ahead. Physiotherapists’ knowledge of evidence in terms of assessment and management of knee OA may influence the implementation of evidence-based practice. However, physiotherapist’s practice patterns are usually based on their professional experience or expert opinions. The present study aimed to explore the evidence awareness among Indian physiotherapists and identify their practice patterns in patients with knee OA.

Methods: An online cross-sectional survey was conducted among Indian physiotherapists. The survey was designed using current clinical practice guidelines and previously published similar studies. The survey consisted of three sections: (1) demographic details, (2) questions related to evidence awareness, (3) questions related to the practice patterns of Indian physiotherapists. The evidence awareness and practice patterns of physiotherapists were explored.

Results: A total of 165 responses were received and analyzed. Most participants perceived footwear modifications (21.2%) and resistance exercises (44.2%) as having very strong evidence. Range of motion assessment and functional assessment was regarded as a must during the patient’s initial visit. In terms of management strategies majority of the participants considered patient education (n=122), strengthening exercises (n=81), and therapeutic ultrasound (n=79) as their treatment of choice.

Conclusion: Most physiotherapist assessment strategies were aimed at identifying impairments in patients. In line with the clinical practice guidelines, most physiotherapists use patient education and strengthening exercises to treat patients with knee OA. However, treatment modalities like ultrasound, TENS, and dry needling, which lack scientific support, are still being used by the physiotherapist. There is a lack of coherence between physiotherapists’ evidence awareness and their choice of management strategies.

KEY WORDS: Knee, Osteoarthritis, Survey, Resistance exercises.

REFERENCES

[1]. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet 2019; 393: 1745–59.
[2]. Sharma L. Osteoarthritis of the Knee. N Engl J Med 2021; 384: 51–9.
[3]. Mahendira L, Jones C, Papachristos A, Waddell J, Rubin L. Comparative clinical and cost analysis between surgical and non-surgical intervention for knee osteoarthritis. Int Orthop 2020; 44: 77–83.
[4]. Martel-Pelletier J, Barr AJ, Cicuttini FM, et al. Osteoarthritis. Nat Rev Dis Prim 2016; 2. DOI:10.1038/nrdp.2016.72.
[5]. JORDAN JM, HELMICK CG, RENNER JB, et al. Prevalence of Hip Symptoms and Radiographic and Symptomatic Hip Osteoarthritis in African Americans and Caucasians: The Johnston County Osteoarthritis Project. J Rheumatol 2009; 36: 809–15.
[6]. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. the framingham osteoarthritis study. Arthritis Rheum 1987; 30: 914–8.
[7]. Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29–30: 100587.
[8]. Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop 2016; 50: 518–22.
[9]. Zhang Y, Jordan JM. Epidemiology of Osteoarthritis. Rheum Dis Clin North Am 2008; 34: 515–29.
[10]. Ayanniyi O, Egwu RF, Adeniyi AF. Physiotherapy management of knee osteoarthritis in Nigeria—A survey of self-reported treatment preferences. Hong Kong Physiother J 2017; 36: 1–9.
[11]. Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthr Cartil 2013; 21: 1145–53.
[12]. James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1789–858.
[13]. Zhang W, Doherty M, Peat G, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis 2010; 69: 483–9.
[14]. Kolasinski SL, Neogi T, Hochberg MC, et al. American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol 2020; 72: 220–33.
[15]. Fernandes L, Hagen KB, Bijlsma JWJ, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 2013; 72: 1125–35.
[16]. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthr Cartil 2019; 27: 1578–89.
[17]. Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: Strengthening exercise programs. Clin Rehabil 2017; 31: 596–611.
[18]. Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: Aerobic exercise programs ∗. Clin Rehabil 2017; 31: 612–24.
[19]. Spitaels D, Hermens R, Van Assche D, Verschueren S, Luyten F, Vankrunkelsven P. Are physiotherapists adhering to quality indicators for the management of knee osteoarthritis? An observational study. Musculoskelet Sci Pract 2017; 27: 112–23.
[20]. da Costa BR, Vieira ER, Gadotti IC, et al. How do physical therapists treat people with knee osteoarthritis, and what drives their clinical decisions? A population-based cross-sectional survey. Physiother Canada 2017; 69: 30–7.
[21]. Suhail A. Knee Osteoarthritis. 2021. https://www.researchgate.net/project/Knee-Osteoarthritis-8 (accessed June 15, 2021).
[22]. Manara M, Bortoluzzi A, Favero M, et al. The Italian Society for Rheumatology clinical practice guidelines for the diagnosis and management of knee, hip and hand osteoarthritis. Reumatismo 2019; 65: 4–21.
[23]. Messier SP, Resnik AE, Beavers DP, et al. Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better? Arthritis Care Res (Hoboken) 2018; 70: 1569–75.

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